A Short Historical Review and Comparative Results of Surgical Treatment for Varicocele

Abstract

Surgery of varicocele dates back to the first century A. D.; Hotchkiss [18] reports on Celsus, who seems to have performed the first documented ligation and cauterization of a varicocele. In 1541, Ambroise Paré [30] described a condition of “compact groups of vessels [in the scrotum] filled with melancholic blood”. If one interpretes “melancholic” as “quiet, slow” then one might assume that Paré was aware of blood stasis in varicocele veins. For centuries, varicocele was treated solely in order to relieve the dragging weight and pain (Table 1). In 1833, Bumstead and Taylor [5] described several of the approaches then used for treatment and palliation. Rather popular was a complicated suspensory for the testes which exerted pressure on the varicocele and had to be attached to an abdominal belt. The surgical method described by these authors, the so-called Woods operation centred on the scrotal contents and consisted of passing wire loops under tension around the vessels in the scrotum and leaving them in place until they eventually cut themselves out. Obviously, abscess formation and ulceration of the scrotal skin was the rule. R. F. Weir [cited in 16] later modified the procedure by introducing a spring steel clamp to apply tension and removing the wires before they cut themselves out of the scrotum. Another surgical tool was the so-called Andrew’s varicocele clamp [15].